<%@page pageEncoding="UTF-8" contentType="text/html; UTF-8" isELIgnored="false" %>
<!doctype html>
<html>
    <head>
        <meta charset="UTF-8">
        <title>病人信息录入</title>
        <link rel="stylesheet" href="/res/css/AddReg.css" type="text/css"/>
    </head>
    <body>
        <p>病人诊断信息的录入</p>
        <form action="/SickAddServlet" method="post">
            <table border="0">
                <tr>
                    <td class="t1">就诊卡号</td>
                    <td><input type="text" name="card_number"/></td>
                    <td class="t1">药品编号</td>
                    <td><input type="text" name="record_number"/></td>
                </tr>
                <tr>
                    <td class="t1">病人姓名</td>
                    <td><input type="text" name="patient_name"/></td>
                    <td class="t1">病人性别</td>
                    <td>
                        <input type="radio" name="patient_gender" checked="checked" value="男"/>男
                        <input type="radio" name="patient_gender" value="女"/>女
                    </td>
                </tr>
                <tr>
                    <td class="t1">医生编号</td>
                    <td><input type="text" name="doctor_number"/></td>
                    <td class="t1">医生姓名</td>
                    <td><input type="text" name="doctor_name"/></td>
                </tr>
                <tr>
                    <td class="t1">医生职称</td>
                    <td><input type="text" name="doctor_title"/></td>
                    <td class="t1">药品名称</td>
                    <td><input type="text" name="drug_name"/></td>
                </tr>
                <tr>
                    <td class="t1">药品规格</td>
                    <td><input type="text" name="drug"/></td>
                    <td class="t1">药品数量</td>
                    <td><input type="text" name="drug_quantity"/></td>
                </tr>
                <tr>
                    <td class="t1">诊断结果</td>
                    <td><input type="text" name="diagnosis_result"/></td>
                    <td class="t1">治疗方法</td>
                    <td><input type="text" name="treatment_method"/></td>
                </tr>
                <tr>
                    <td class="t1">就诊科室</td>
                    <td>
                        <select id="s2" name="department_name">
                            <option value="呼吸内科门诊">呼吸内科门诊</option>
                            <option value="消化内科门诊">消化内科门诊</option>
                            <option value="神经内科门诊">神经内科门诊</option>
                            <option value="心血管内科门诊">心血管内科门诊</option>
                            <option value="血液内科门诊">血液内科门诊</option>
                            <option value="肾病学门诊">肾病学门诊</option>
                            <option value="变态反应门诊">变态反应门诊</option>
                            <option value="老年病门诊">老年病门诊</option>
                            <option value="性传播疾病专业">性传播疾病专业</option>
                        </select>
                    </td>
                    <td class="t1">诊断时间</td>
                    <td><input type="text" name="diagnosis_time"/></td>
                </tr>
            </table>
            <div class="div1">
                <input type="submit" value="提交"/>
                <button><a href="/SickShowAll">返回</a></button>
            </div>
        </form>
    </body>
</html>